College of LAS « Illinois

Alumni Profile

Being There

Round-the-clock commitment keeps the mentally ill
out of jail.

John Fallon (B.S. '83, psychology) first met Kathy
Powell at 7:30 p.m. on a brisk April evening. She was standing outside the front
doors of the psychiatric treatment center where he works, holding a bundle of
clothes and clutching a card with the name of the center—Thresholds. She
had been released from Cook County Jail a day earlier than expected, which meant
that Fallon had to miss his son's soccer game and rush back into the city
to meet her. Waiting until the morning wasn't an option.

Because Kathy is schizophrenic, Fallon knew that every hour counted. When she
is on medication, she is able to recall the names of her grandchildren and dream
about a future. If her treatment lapses, she becomes disordered, hears voices,
and falls prey to the pattern of behavior that landed her in jail in the first
place.

"My job is to get people like Kathy to take their medication," says
Fallon. "Then, during that short interval when they see the world as the
rest of us do, I try to make that world a good one so that they'll stay
in it."

Prior to the 1950s, the mentally ill were locked away in institutions such
as the gothic-looking state mental health facility in Manteno, IL. Mainstreaming
gained favor in the 1960s as the first wave of pharmaceuticals demonstrated that
many otherwise disruptive behaviors often could be controlled with medication.
Controlled, however, does not mean cured, and therein lies the problem that Fallon
is addressing.

"Mental illness happens
seven days a week.
Care has to be the same."—John Fallon

Fallon, 42, is project leader for an innovative program run by Thresholds,
a large private psychiatric facility on Chicago's north side. This project
provides aftercare to persons coming from Cook County Jail. Called the Thresholds
Jail Program, it is trying to break the cycle of drug abuse, incarceration, hospitalization,
and homelessness into which many of the mentally ill fall.

At any given time, nearly a quarter of a million mentally ill adults are incarcerated
in the country's prisons and jails. While there, they usually receive good
care. Problems start, however, when they are released.

"Once they leave custody, there is little or no follow-up, no assurances
they will take or can even pay for their medication," says Fallon. "They
are let go on a darkened street in the middle of the night with no money, with
only the name and phone number of a treatment center scrawled on a piece of paper,
and no guarantees that the center has room for them. They are expected to fend
for themselves."

Fallon
is a long-time advocate of residential and community-based care. While still at
UI, he worked as a live-in counselor at a home for runaway teens. When his father
died, he dropped out for a year to be a houseparent at a home for
emotionally disturbed youth. These experiences, plus the strong background he
got at UI in psycho-social behavior, convinced him that caring for the mentally
ill, like parenthood, meant being available when needed.

Believing that society pays now or pays later, Fallon and Thresholds try to
"be there" for the jailed mentally ill. Participants are recommended
to Thresholds by doctors at Cook County Jail. Like Kathy, all participants are
nonviolent and responsive to medication even though they may have been arrested
and/or psychiatrically hospitalized more than 100 times. Caseworkers meet them
at the jail when they are released and find them an apartment in one of the residential
hotels near Thresholds so that assistance is readily available. They are given
an allowance and taught how to care for themselves and how to hold a job. A caseworker
visits every day—including holidays—to ensure that they are taking
their medication. The daily contact usually lasts a year but will continue as
long as necessary. Fallon has talked with one "member," as Thresholds
calls program participants, every day for two years. All caseworkers are on-call
24 hours a day.

This open-ended commitment is a big reason the program seems to be working.
During the program's five years, it has helped more than a hundred men and
women stay out of jail. Initial results far surpassed anyone's expectations. Incarceration among participants is down more than 80 percent, and hospitalization
is down more than 80 percent. These results were so surprising that the American
Psychiatric Association gave the program its prestigious Gold Achievement Award
for 2002 as the nation's top small community-based program. These results
are only achieved one person at a time.

On Kathy's first night out of jail, Fallon found her a room, took her
shopping for necessities, and bought her a small radio. She still has the radio
even though she bought a larger one last winter with money she earned at her new
job.

"Mental illness happens seven days a week," says Fallon. "Care
has to be the same."